He refuses to part with them
As a dental hygienist for many years, I’ve had my fair share of cases of edentulism, or toothlessness, but I’ve made a discovery that completely changes the concept as a whole. Recently, I had an interaction with a patient unlike any other in my career. I have come to believe that toothlessness can be the result of an inability to lose one’s primary teeth, or “baby teeth,’’ and that the inability to do so may be influenced by one’s own mental state.
A few weeks ago, I had an appointment with a young man who, for the sake of his own privacy, I will refer to as “Greg.” When Greg made his appointment over the phone, he claimed his health record was normal, and that his visit was standard– primarily for cosmetic reasons. I figured I would give him a general examination and refer him to an orthodontist if he needed.
When Greg came in for his appointment, he was seemingly a fairly normal patient. What struck me as a little out of the ordinary was the fact that Greg wasn’t alone when he came in. An older woman, maybe late fifties, was on his arm. Or rather, HE was hanging on to HER arm. Intrigued, I watched them from behind my receptionist’s desk.
Greg’s demeanor was incredibly nervous. He was hanging onto the woman’s arm as if he didn’t have a choice. It became clear that she was his mother, accompanying her son to the dentist. I made eye contact with Greg in attempt to get a read on him, but he quickly dodged my gaze and buried his face into his mother’s shoulder.
I was a bit put off, but I was prepared to continue with Greg’s visit as I would with any other patient. I walked around to the lobby area and called him back to the examination room to begin his inspection.
When Greg finally opened his mouth, I saw nothing. No teeth, that is. I only saw gums. Huge gums– biggest I’ve ever seen– almost like his full smile was just pink. I was confused as to why Greg hadn’t just tried to order dentures or go through me to schedule an appointment for fake teeth to be put in. These are the routes those who suffer from his condition typically take.
I looked closer at Greg’s mouth, and saw that toothlessness wasn’t the issue at all. There were small, pointed, white knobs sticking out from his gums. The knobs were spaced far apart from each other, like tiny little tic-tacs. Like the teeth of a three-year-old.
I asked Greg when he had last received dental work. He said that his visit with me was his first. Of course, this was both incredibly flattering and unsettling. I then asked Greg if his teeth caused him day-to-day trouble, a question that provoked Greg to immediately get defensive of his teeth, nearly driven to tears.
Greg said he liked his teeth, and the sole reason he was at a dentist was to make his mother happy. She was tired of having to prepare softer meals specifically to suit his needs. My initial suggestion was to have Greg’s primary teeth removed, see if his adult teeth grew in, and go from there. I was starting to explain options for false teeth when Greg became red in the face and began to shake.
He pulled a teething ring out his pocket and began violently chewing on it. I was taken aback by this behavior, as I’d never seen such a connection between one’s dental and mental state. I began to take hint of how to approach Greg’s issue, and asked if he would like me to inform his mother of this behavior.
After this proposal, Greg was ready to participate. We took X-rays of his teeth and learned that he did indeed have adult teeth above his primaries, which meant it was safe remove them.
But I came to another dilemma. Since I had not experienced such a condition, I had no idea how to treat it. My first thought was traditional—pulling out each tooth, but this suggestion only resulted in violent kicking and screaming from Greg.
Seemingly nothing worked. Through each attempt to numb Greg, he would throw a fit. The only method Greg could get behind was my politely asking his teeth to please come out.
It sounds preposterous, but I genuinely think we saw slight results from this method. Regardless, it was incredibly slow moving, and that’s all I was left with.
Greg and I have another appointment scheduled for next week, but I have yet to come up with a solution that fixes his issue while meeting his needs.
This is in part why I’m writing this. If any dental experts have ever heard of a similar case and have potential solutions, please, please contact me as soon as possible. Truly, I will be taking any suggestions.
Phoebe Harms is a second-year journalism major who still keeps their back molar to remind them of childhood. You can reach them at firstname.lastname@example.org.